Prognostic impact of perirenal fat stranding on oncologic outcomes in ureteral urothelial carcinoma

Chung, Jae-Wook; Lee, Jun Nyung; Park, Kyong Min; Byeon, Kyeong-Hyeon; Cheon, Hyejin; Ha, Yun‐Sok; Choi, Seock Hwan; Kim, Bum Soo; Kim, So Yeon; Yoo, Eun Sang; Kwon, Tae Gyun; Kim, Hyun Tae

doi:10.4111/icu.20200125

Cited by 3 publications

(8 citation statements)

References 31 publications

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“…There have been several studies on PRFS with hydronephrosis [9][10][11][12][13][14][15]. In general, the occurrence of PRFS with hydronephrosis can be explained by the following two reasons.…”

Section: Discussionmentioning

confidence: 99%

“…In general, the occurrence of PRFS with hydronephrosis can be explained by the following two reasons. The rst possible explanation is that in ammation and bridging septa brosis may result from extravasated urine [9,13]. When the ureter becomes obstructed, increased intrarenal pelvic pressure results in a microscopic rupture at the calyceal fornix, which is the area of least resistance, and pyelosinus back ow of urine may occur.…”

Section: Discussionmentioning

confidence: 99%

“…Several studies have investigated the risk factors for local or metastatic recurrence after RNU and identi ed hydronephrosis on preoperative computed tomography (CT) [4,5], lymphovascular invasion (LVI) [6,7], and positive surgical margin [8]. Recently, ipsilateral perirenal fat stranding (PRFS) has also been reported as a risk factor for recurrence after RNU for ureteral urothelial carcinoma (UUC) with hydronephrosis [9].…”

Section: Introductionmentioning

confidence: 99%

“…PRFS is often recognized as a linear or curvilinear area of soft-tissue attenuation in the perirenal fat space on CT. There have been reports of PRFS due to pyelonephritis and ureteral stones with hydronephrosis in benign diseases [10,11] and reports of RPFS due to UUC with hydronephrosis in cancers [9]. However, PRFS in renal pelvic urothelial carcinoma (RPUC) without hydronephrosis has not been reported.…”

Section: Introductionmentioning

confidence: 99%

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Perirenal fat stranding as a predictor of disease progression after radical nephroureterectomy for renal pelvic urothelial carcinoma: A retrospective study

Yanagi

Terasaki

Kiriyama

et al. 2023

Preprint

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Background To investigate the impact of Perirenal fat stranding (PRFS) on progression after radical nephroureterectomy (RNU) for pelvic urothelial carcinoma (RPUC) without hydronephrosis and to reveal the pathological findings of PRFS. Methods Clinicopathological data, including computed tomography (CT) findings of the ipsilateral and contralateral PRFS, were collected from the medical records of 56 patients treated with RNU for renal RPUC without hydronephrosis between 2011 and 2021 at our institution. Ipsilateral PRFS on CT was classified as either low or high PRFS. The impact of PRFS on progression-free survival (PFS) after RNU was analyzed using the Kaplan-Meier method and log-rank test. In addition, specimens including sufficient perirenal fat from patients with low and with high PRFS were pathologically analyzed. Results Of the 56 patients, 31(55.4%) and 25 (44.6%) patients were classified as having low and high PRFS, respectively. Within a median follow-up of 40.6 months postoperatively, 11 (19.6%) patients showed disease progression. The Kaplan-Meier method and log-rank test revealed that patients with ipsilateral high PRFS had significantly lower PFS rates than those with ipsilateral low PRFS (3-year PFS 69.8% vs 93.3%; p=0.0393). Pathological analysis revealed that ipsilateral high PRFS specimens (n=3 patients) contained more fibrous strictures in perirenal fat than ipsilateral low PRFS specimens (n=3 patients). Conclusions PRFS of RPUC without hydronephrosis consists of collagenous fibers. The presence of ipsilateral high PRFS is a risk factor for progression after RNU for RPUC patients without hydronephrosis. Strict follow-up after surgery is thus recommended for these patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Perirenal fat stranding as a predictor of disease progression after radical nephroureterectomy for renal pelvic urothelial carcinoma: A retrospective study

Yanagi

Terasaki

Kiriyama

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

“…Several studies have investigated the risk factors for local or metastatic recurrence after RNU and identified hydronephrosis on preoperative computed tomography (CT) [ 4 , 5 ], lymphovascular invasion (LVI) [ 6 , 7 ], and positive surgical margin [ 8 ]. Recently, perirenal fat stranding (PRFS) has also been reported as a risk factor for recurrence after RNU for ureteral urothelial carcinoma (UUC) with hydronephrosis [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Perirenal fat stranding as a predictor of disease progression after radical nephroureterectomy for renal pelvic urothelial carcinoma: a retrospective study

et al. 2023

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Background To investigate the impact of Perirenal fat stranding (PRFS) on progression after radical nephroureterectomy (RNU) for renal pelvic urothelial carcinoma (RPUC) without hydronephrosis and to reveal the pathological findings of PRFS. Methods Clinicopathological data, including computed tomography (CT) findings of the ipsilateral PRFS, were collected from the medical records of 56 patients treated with RNU for RPUC without hydronephrosis between 2011 and 2021 at our institution. PRFS on CT was classified as either low or high PRFS. The impact of PRFS on progression-free survival (PFS) after RNU was analyzed using the Kaplan–Meier method and log-rank test. In addition, specimens including sufficient perirenal fat from patients with low and with high PRFS were pathologically analyzed. Immunohistochemical analysis of CD68, CD163, CD3, and CD20 was also performed. Results Of the 56 patients, 31(55.4%) and 25 (44.6%) patients were classified as having low and high PRFS, respectively. Within a median follow-up of 40.6 months postoperatively, 11 (19.6%) patients showed disease progression. The Kaplan–Meier method and log-rank test revealed that patients with high PRFS had significantly lower PFS rates than those with low PRFS (3-year PFS 69.8% vs 93.3%; p = 0.0393). Pathological analysis revealed that high PRFS specimens (n = 3 patients) contained more fibrous strictures in perirenal fat than low PRFS specimens (n = 3 patients). In addition, M2 macrophages (CD163 +) infiltrating fibrous tissue in perirenal area were observed in all patients with high PRFS group. Conclusions PRFS of RPUC without hydronephrosis consists of collagenous fibers with M2 macrophages. The presence of ipsilateral high PRFS might be a preoperative risk factor for progression after RNU for RPUC patients without hydronephrosis. Prospective studies with large cohorts are required in the future.

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Role of Renal Parenchyma Attenuation and Perirenal Fat Stranding in Chest CT of Hospitalized Patients with COVID-19

Russo¹,

Tagliafico

Derchi

et al. 2023

JCM

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Background: Chest CT on coronavirus disease (COVID-19) has been extensively investigated. Acute kidney injury (AKI) has been widely described among COVID patients, but the role of kidney imaging has been poorly explored. The aim of this study is to clarify the role of opportunistic kidney assessment on non-enhanced chest CT. Methods: We collected data on patients with COVID-19 consecutively admitted to our institution who underwent chest CT (including the upper parts of kidneys as per protocol). Three ROIs of 0.5–0.7 cm2 were positioned in every kidney. The values of renal parenchyma attenuation (RPA) and the presence of perirenal fat stranding (PFS) were analyzed. The primary and secondary outcomes were the occurrence of AKI and death. Results: 86 patients with COVID-19 and unenhanced chest CT were analyzed. The cohort was split into CT RPA quartiles. Patients with a CT RPA <24 HU were more likely to develop AKI when compared with other patients (χ2 = 2.77, p = 0.014): at multivariate logistic regression analysis, being in the first quartile of CT RPA was independently associated with a four times higher risk of AKI (HR 4.56 [95% CI 1.27–16.44, p = 0.020). Within a mean 22 ± 15 days from admission, 32 patients died (37.2%). Patients with PFS were more likely to die as compared to patients without it (HR 3.90 [95% CI 1.12–13.48], p = 0.031). Conclusions: Detection of low RPA values and of PFS in COVID-19 patients independently predicts, respectively, the occurrence of AKI and an increased risk for mortality. Therefore, opportunistic kidney assessment during chest CT could help physicians in defining diagnostic and therapeutic strategies.

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Prognostic impact of perirenal fat stranding on oncologic outcomes in ureteral urothelial carcinoma

Cited by 3 publications

References 31 publications

Perirenal fat stranding as a predictor of disease progression after radical nephroureterectomy for renal pelvic urothelial carcinoma: A retrospective study

Perirenal fat stranding as a predictor of disease progression after radical nephroureterectomy for renal pelvic urothelial carcinoma: A retrospective study

Perirenal fat stranding as a predictor of disease progression after radical nephroureterectomy for renal pelvic urothelial carcinoma: a retrospective study

Role of Renal Parenchyma Attenuation and Perirenal Fat Stranding in Chest CT of Hospitalized Patients with COVID-19

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